Background: Oligohydramnios, characterized by a low Amniotic Fluid Index (AFI), is associated with adverse pregnancy outcomes, including fetal growth restriction, preterm labor, and low birth weight. Effective interventions for improving AFI are critical, particularly in resource-limited settings. L-Arginine, a nitric oxide precursor, has shown promise in enhancing uteroplacental circulation and increasing AFI. This study aimed to evaluate the efficacy of L-Arginine supplementation in improving AFI and associated maternal and neonatal outcomes in pregnant women with oligohydramnios in Bangladesh. Methods: This study was conducted at Islami Bank Hospital over one year (July 2023 to June 2024), involving 90 pregnant women diagnosed with oligohydramnios. Participants received daily L-Arginine supplementation, and AFI was measured before and after the intervention. Maternal and neonatal outcomes, including gestational age at delivery, birth weight, and neonatal intensive care unit (NICU) admissions, were recorded. Statistical analysis was performed using paired t-tests, with p < 0.05 considered statistically significant. Results: The mean AFI increased significantly from 5.4 cm (SD ±1.7) before the intervention to 8.6 cm (SD ±2.1) after supplementation, with a mean difference of 3.2 cm (p < 0.001). Low birth weight was observed in 20% of the neonates, while 17.78% required NICU admission. There was a notable improvement in neonatal outcomes with L-Arginine supplementation. Conclusion: L-Arginine supplementation significantly improved AFI and neonatal outcomes, making it a viable intervention for managing oligohydramnios in pregnant women. Further research is recommended to confirm these findings in larger populations.
ORIGINAL RESEARCH ARTICLE | Oct. 9, 2024
Fetomaternal Outcome in Pregnancy with Gestational Thrombocytopenia
Nujhat Sharmin Urmi, Mustak Ahmmed Ruhel, Natia Rahnuma, Iffana Azam, Rukshana Khan, Tahmina Sharmin, Mahmuda Jannat
Page no 482-487 |
DOI: https://doi.org/10.36348/sijog.2024.v07i10.002
Introduction: Gestational thrombocytopenia, a common hematological disorder in pregnancy, poses risks to both maternal and neonatal health. This study aims to evaluate the fetomaternal outcomes in pregnancies complicated by gestational thrombocytopenia compared to those with normal platelet counts. Methods: This prospective cohort study was conducted over 12 months at Jalalabad Ragib-Rabeya Medical college hospital sylhet Bangladesh. It included 100 pregnant women diagnosed with gestational thrombocytopenia (platelet count <150,000/µL after 20 weeks of gestation) and 100 matched controls with normal platelet counts. Maternal data included demographic information, obstetric and medical history, mode of delivery, incidence of pre-eclampsia, postpartum hemorrhage, and need for platelet transfusions. Fetal outcomes assessed were birth weight, Apgar scores, preterm birth rates, NICU admissions, and neonatal thrombocytopenia. Data were analyzed using t-tests for continuous variables and chi-square tests for categorical variables, with multivariate logistic regression to identify predictors of adverse outcomes. Result: The gestational thrombocytopenia group showed higher, though not statistically significant, rates of cesarean delivery (30% vs. 25%, p=0.453), pre-eclampsia (15% vs. 12%, p=0.540), and postpartum hemorrhage (18% vs. 10%, p=0.110). Platelet transfusions were required more frequently in the gestational thrombocytopenia group (8% vs. 2%, p=0.052). Fetal outcomes revealed lower mean birth weight (2950g vs. 3050g, p=0.145), higher preterm birth rates (14% vs. 10%, p=0.371), and more NICU admissions (20% vs. 12%, p=0.132) in the gestational thrombocytopenia group. Notably, neonatal thrombocytopenia was significantly more prevalent in the gestational thrombocytopenia group (10% vs. 2%, p=0.017). Conclusion: Gestational thrombocytopenia is associated with increased risks of certain maternal and neonatal complications. Vigilant monitoring and management are essential to improve outcomes in affected pregnancies. Further research is needed to develop targeted interventions and improve antenatal care practices.
ORIGINAL RESEARCH ARTICLE | Oct. 11, 2024
Psychological Effects Arising from Weak Erection Among males in South-South Nigeria
Gbaranor K. B., Imarhiagbe O. C., Mube A. W., Pepple, B. G., Ogbonda N. P., Cookey-Gam I. F., Kue B. J., Mgbere M., Maakai B., Ekeng O., John E. E., Etim D. N., Kinanen D. L.
Page no 488-492 |
DOI: https://doi.org/10.36348/sijog.2024.v07i10.003
Weak erection among male are on the increased and caused psychological trauma to male and also to their female counterpart who could not get satisfaction from their partners during sexual intercourse and it is a disturbing act Majority of the males facing weak erection pass through several degrees of psychological trauma that have affected their biopsychological system including their cognitive response. The aim of the study is to evaluate The Psychological Effects Arising from Weak Erection Among males in South-South, Nigeria. This was a cross-sectional study involving 480 males who were within the age of 18 to 47 years. A well-structured questionnaire was administered to participants. Each participant had one questionnaire to fill appropriately and independently after instructions were given to them by the Research Assistants. The study lasted for a period of 3 months. The results of this study showed that participants faced varieties of psychological complications due to erectile dysfunction and these include depression (83.3%), shame (83.3%), isolation (60.4%), negative self-esteem (83.3%), (2.08%) said they could not approach ladies of their choice, (83.3%) felt embarrassed, (79.2%) thought deeply and (72.92%) said they could not coordinate themselves. The statistical analysis was carried out using Statistical Package for Social Science (SPSS) version 23.
Background: Premature birth is the leading cause of newborn morbidity and mortality. This study sought to evaluate the outcomes of preterm delivery in El-Obeid, Sudan. Methodology: A prospective descriptive study was conducted in the Obstetrics and Gynecology Hospital in El-Obeid, North Kordofan State, Sudan, from January 2023 to December 2024. The study encompassed approximately 106 hospitalized women with a gestational age below 37 weeks. Results: The largest G.A. at risk were 34 weeks, followed by 35 weeks, with figures of 26/106 (24.5%) and 20/106 (19%). The majority of deaths occurred at 30 G.A. (27%). The most common risk factor was premature rupture of membranes (PPROM), followed by postpartum hemorrhage (PPH), which accounted for 45% and 39%, respectively. Antepartum hemorrhage caused the majority of deaths (49%) in Sudan. Conclusion: Preterm birth is widespread in Sudan, with severe consequences, the most common being death. Although postpartum hemorrhage is the most common risk factor, antepartum hemorrhage is becoming more closely associated with death.
ORIGINAL RESEARCH ARTICLE | Oct. 22, 2024
Contribution of Ultrasound in the Management of Haemorrhages in the Third Trimester of Pregnancy at the Kalabancoro Reference Health Center, Mali 2023
Haïdara Mamadou, Guindo Issa, Traore S. Mamadou, Koné Aboubacar, Diakite L. Abdoulaye, Coulibaly Mahamoudou, Diallo Seydou, Kone S Bocary, Mamadou B. Coulibaly, Seydou Z. Dao, Alou Samaké, Mahamadou Diassana, Dembélé Sitapha, Macalou Ballan, Sidibé Alima, Maiga Fatoumata, Sanogo Ousmane, Kaba K Mohamed, Mariko Seydou, Maiga Malick, Bamba Brahima, Diarra Tiefolo, Sanogo Harouna, Diarra Mohamed, Berthe Bakary, Nitiama Moussa, Kamate Auguistin, I Coulibaly, Bocoum Amadou, ...
Page no 499-505 |
DOI: https://doi.org/10.36348/sijog.2024.v07i10.005
Introduction: Haemorrhages in the third trimester of pregnancy are nowadays a frequent situation that can jeopardize the maternal-fetal prognosis. Given its scale and degree of seriousness, this work was initiated to assess the contribution of ultrasound in its management. Material and Methods: This was a descriptive cross-sectional study with retrospective data collection which took place at the Kalabancoro Reference Health Center from May 1, 2022 to October 31, 2022. Its objective was to study the contribution of ultrasound in the management of haemorrhage in the third trimester of pregnancy. Results: During the study, 154 cases of haemorrhage in the third part of pregnancy out of 2,546 pregnancies were recorded, representing a frequency of 3.4%. The average age of the patients was 27 ± 3.5 years with extremes of 16 and 38 years. Married women were the most represented with 84.4%. Out-of-school women were the most represented, accounting for 63.6% of cases. Multiparous women were the most represented with 39.6% cases. Arterial hypertension was the most common medical history, i.e. 66.6%. Bleeding during pregnancy was the most frequent reason for consultation with 87.6%. Retroplacental hematoma was the predominant etiology, i.e. 67.5%. In utero fetal death was found in 54.5% of cases. Conclusion: The contribution of ultrasound was very important in the therapeutic decision-making. Emergency caesarean section was performed in 66.7% of cases.
Background: Abortion remains a critical public health issue, particularly in low-resource settings like Bangladesh, where access to safe abortion services is often restricted. This study aimed to analyze the types of abortions, treatment methods, and post-abortion complications in a tertiary hospital in Bangladesh. Methods: A cross-sectional study was conducted from January to December 2017, including 100 cases of abortion at a 250-bed district hospital in Joypurhat, Bangladesh. Data were collected from patient records, focusing on demographic characteristics, type and nature of abortion, treatment methods, and complications. Descriptive statistics were used for analysis. Results: The majority of patients (42%) were aged 26–30 years, and 58% were primigravida. Most abortions (75%) occurred before 13 weeks of gestation, with incomplete abortions accounting for 86% of cases. Spontaneous abortions constituted 86%, and D&C was the primary treatment method in 83% of cases. Post-abortion complications were infrequent, with incomplete D&C (8%), shock (6%), and septicemia (3%) being the most common. Conclusion: Incomplete abortions and spontaneous abortions are the most common types observed, with D&C being the predominant treatment method. Although complications were low, the findings underscore the need for better access to safe abortion methods, including medical abortion, and the reduction of unsafe practices through improved healthcare education and policy reform.
ORIGINAL RESEARCH ARTICLE | Oct. 30, 2024
Investigation on the Association of Maternal Serum Visfatin Concentration with Gestational Diabetes Mellitus
Hasina Begum, Firoza Begum, Nahreen Akhtar, Salma Rouf, Saborni Sarker, Fahmida Khatun
Page no 511-521 |
DOI: https://doi.org/10.36348/sijog.2024.v07i10.007
Introduction: Gestational diabetes mellitus (GDM) is a common pregnancy complication that can have adverse effects on both the mother and the child. Visfatin, an adipokine, has been suggested to play a role in the pathogenesis of GDM. Still, the association between maternal serum visfatin concentration and GDM remains unclear, particularly in the Bangladeshi female population. This study investigated the association between maternal serum visfatin concentration and GDM in the Bangladeshi female population. Methods: A total of 69 patients participated in this study, including 34 patients with gestational diabetes mellitus (GDM, cases) and 35 patients without GDM (non-GDM, controls). Maternal age, gravida, pre-pregnancy BMI, family history of diabetes, fasting glucose, fasting insulin, HOMA-IR, and lipid profile were assessed. Serum visfatin concentrations were measured and compared between the two groups. Results: The GDM group had significantly lower serum visfatin concentrations compared to the non-GDM group (0.72±0.38 ng/ml vs 1.12±0.7 ng/ml, p<0.001). The Mean±SD of fasting glucose, fasting insulin, and HOMA-IR were 5.83±0.61, 15.77±3.95, and 4.07±1.09 respectively which were significantly higher in the GDM group. In the serum lipid profile study, the Mean±SD value of TG and HDL (3.05±0.82 and 1.63±0.32) in the GDM group were also significantly higher than that of the non-GDM group (2.45±0.88 and 1.49±0.36) (P < 0.05). Conclusions: This study suggests that lower maternal serum visfatin concentrations are associated with GDM and visfatin levels are inversely related to insulin resistance in women with GDM. Consequently, a potential role of visfatin in the pathogenesis and management of GDM is associated with the Bangladeshi population and thus visfatin may represent a novel diagnostic or prognostic biomarker for GDM. Therefore, further research will be valuable to elucidate the underlying mechanisms and explore the clinical implications of these associations.
ORIGINAL RESEARCH ARTICLE | Oct. 30, 2024
Electrocardiographic Changes in Second and Third Trimester in Bangladesh: A Comparative Study
Farzana Siddiqui, Md Fakhrul Alam, Afsana Rahman, Shamima Akter Baby
Page no 522-526 |
DOI: https://doi.org/10.36348/sijog.2024.v07i10.008
Background: During pregnancy, there are notable changes in cardiovascular function to meet the increasing needs of the developing baby. The objective of this study was to compare ECG in pregnant women during their second and third trimesters with a control group of non-pregnant women in Bangladesh. This study aims to offer valuable insights into the cardiovascular changes that happen during pregnancy. This study's findings are important for maternal health research and clinical practice in Bangladesh and beyond. Objective: The purpose of this study is to analyze and compare the ECG variations in women during the second and third trimesters of pregnancy. Methods: The study took place in the gynecology Department at CMH Saidpur, Bangladesh. This study was conducted from March 2023 to August 2023. During this period, 75 pregnant patients in their 2nd trimester and 75 patients in their 3rd trimester were chosen as cases from antenatal outdoor, while 75 non-pregnant women of the same age were selected as the control group. We use the purposive sampling method. Results: During pregnancy, there were notable changes in BMI, heart rate, and PR interval. BMI decreased in the second trimester and increased in the third trimester.22.67% were nulliparous and 77.33% were multiparous in 2nd trimester. In the third trimester, 26.67% were nulliparous and 73.33% multiparous. So, no significant difference in parity. Heart rate increased in both trimesters, while the PR interval shortened in both trimesters. No significant changes were observed in the durations of the QRS complex or QT interval. In our study, the QTc interval displayed a significant rise. ST depression, which may suggest decreased blood flow, was exclusively seen in pregnant women, particularly in the third trimester. Conclusion: We found no significant changes in age, but BMI, heart rate, and PR interval were significantly different from the control group throughout pregnancy. No significant QRS complex or QT interval duration changes were identified. The QTc interval rose. ST depression, more prominent in the third trimester, only affected pregnant women. As shown by ST depression, pregnancy may change cardiac function, electrical activity, and ischemia.
ORIGINAL RESEARCH ARTICLE | Oct. 30, 2024
Mifepristone-Misoprostol Regimen vs. Surgical Abortion: Evaluating Pregnancy Termination Options in Bangladesh
Dr. Israt Jahan, Lieutenant Colonel Dr. Md Fakhrul Alam, Dr. Rumana Hasan Sharmi
Page no 527-532 |
DOI: https://doi.org/10.36348/sijog.2024.v07i10.009
Background: Access to safe and effective abortion services plays a vital role in safeguarding women's reproductive health, ultimately contributing to their overall well-being. This is particularly relevant in Bangladesh, where the legality of abortion is contingent upon specific circumstances. Therefore, ensuring women have the autonomy to choose between safe and effective termination methods becomes crucial. Objective: The study aims to see explore the efficacy, safety, and accessibility of mifepristone-misoprostol regimen and surgical abortion methods within the context of Bangladesh. Methods: This investigation employed a cross-sectional observational design, conducted within the Department of Obstetrics and Gynecology at Dhaka National Medical College in Bangladesh. The study spanned one year, commencing in March 2023 and concluding in February 2024. To ensure a representative sample of the patient population seeking abortion services, consecutive sampling was utilized. This approach involved recruiting all patients admitted during the designated timeframe who fulfilled the pre-established inclusion and exclusion criteria. Ultimately, the study enrolled 104 participants, a sample size determined by the number of admissions fitting the criteria within the one year. Results: The study found no significant difference in age distribution between women choosing medical or surgical abortion, with both groups mainly consisting of women aged 18-25. Overall complication rates were similar, but medical abortion had a higher need for additional procedures and longer stays, while surgical abortion required more bleeding observation. Pain experiences differed significantly, with no women in the medical group reporting no pain and a higher prevalence of moderate pain compared to surgical abortion. Women undergoing medical abortion were slightly more likely to experience complications overall, and primigravid women (first pregnancy) were significantly more likely to experience complications than multigravid women. Conclusion: Our findings suggest comparable safety profiles for both surgical and medical abortion procedures within the studied population. This indicates that surgical abortion can be a safe and effective option alongside medical abortion, potentially expanding the range of choices offered to women.